Rehabilitation and Hospitals

They work with interdisciplinary teams of experts in a number of fields, to include Nursing, Physical Therapy, Occupational Therapy, Speech and Language Pathology, Psychology, Recreational Therapy, and other Physiatrists in order to improve and maximize each individual's function, quality of life, and independence. Persons who are admitted to a rehabilitation unit in a hospital are likely to meet a Physiatrist.

Benefits of Admission to an Acute Rehabilitation Unit (ACU) - People who experience traumatic injuries such as traumatic brain injuries, or spinal cord injuries; amputations or burns can benefit from the services offered by an ACU. People who have neurological conditions; brain tumors, multiple sclerosis, or movement disorders for example, or have experienced a stroke, can as well. Other people who may benefit from the services offered by an ACU include those who experience arthritis, musculoskeletal disorders, spinal, brain, orthopedic disorders, or a generalized debility or de-conditioning. Post-surgical patients can benefit from these services too.

Common Criteria for Admission - Usually, the person seeking admission to an ACU must meet a few conditions. They must be medically stable, and be able to tolerate three or more hours of intensive rehabilitative therapies throughout the day. The person must need the services of inpatient acute rehabilitative nursing and physiatric, occupational, or speech-language therapy, as well as medical care. The person must have a supportive social network and firm discharge plans in place, as well as the cognitive ability to carry over instructions from day to day. The person has to agree to intensive acute rehabilitation admission.

Inpatient Rehabilitation - The goal of inpatient rehabilitation is to help the person to function as independently as possible, restoring the person to the highest possible physical, psychosocial and vocational independence levels possible. The staff at an inpatient rehabilitation hospital needs to have the goals of protecting the person's rights to privacy, dignity, and self-determination while retaining high ethical standards related to clinical, medical, research and managerial functions. Rehabilitative care programs evaluate the person's outcomes in functional independence, determine the length of their stay in the unit, their discharge into the community, and assess the person's ability to lead a productive lifestyle.

There is a national benchmark used by many inpatient rehabilitation facilities to measure the severity of a person's disability and document it; this benchmarking instrument is known as the, 'Functional Independence Measure (FIM).' The FIM is often used throughout the process of providing rehabilitative services in an ACU in order to monitor changes in functional status related to the person. Satisfaction on the part of the person participating in the rehabilitation process is a vital component since the person's active participation in the treatment program can influence the outcome. Functional outcome information is often used by both Departments of Rehabilitation and Post-Acute Care services in order to determine the clinical effectiveness of management of patients, as well as their ability to meet the needs of what is very often a diverse and multicultural patient population.

Common Patient Rights - Many inpatient rehabilitation units respect the rights people have while in their care. These rights commonly include things such as protection of the person's privacy, provision of enough information to both the person and their family members to make decision-making processes, and information regarding their freedom to take part in research studies, the right to do-not-resuscitate (DNR) status, and their rights regarding advanced directives. Common rights people have during stays in ACU's also include provision of information regarding services which are not provided or covered along with referrals to outside services, sensitivity to both optional treatment practices and cultural beliefs, and prohibition of psychological and physical abuse.

Therapy and Length of Stay - Many times, the person's therapy schedule will be placed in their room, as well as at the Nurse's station every morning. People will often receive three or more hours of therapy each day for five days each week. Their schedule could be changed by their rehabilitation care team to meet their individual needs. Therapy usually begins early in the morning. Team goals are commonly evaluated on a weekly basis by the rehabilitation team, and the person's length of stay is determined by a number of things. These things include their progress towards the goals that have been set, the level of involvement by family members, authorization of stay by the person's payor source, the person's active participation in the program, and their discharge plan.

Personal and Clothing Items - There are some clothing and personal items a person should bring for their stay in an ACU. These items include comfortable pants, gym shoes or footwear that is comfortable, night clothing and a robe, and some personal grooming items. The person should bring some shirts or blouses, a sweatshirt or sweater, some undergarments, and a coat as well. In many ACU's, the person's family members or caregiver is responsible for washing the person's clothes. The person's clothes, glasses, dentures and hearing aides should all be labeled. Any jewelery, cash, credit cards or additional valuables need to be left at home.

Advanced Directives - A number of inpatient rehabilitation hospitals ask people who seek admission for a completed and signed advanced directive prior to admission. An advanced directive is a document that is signed by the person prior to a serious illness, and states their desires regarding how they want medical decisions made. Advanced directives are many times kept with the person's medical records, and are the clearest demonstration of their wishes.

Complaints - Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975 prohibit discrimination on the basis of race, color national origin, sexual orientation, disability and age. Inpatient rehabilitation units are required by law to respect these Acts. Many of these facilities have additional policies in place to ensure that people receiving services are satisfied.

Support Groups - Different rehabilitation units offer different programs where support is concerned. There may be a number of supports available for persons going through rehabilitation related to coping with disability, including community reintegration. Other forms of support may include home safety assessment, dysphagia management, skin and wound management, nutrition management, medication management, orthotic services, audiology services, vision services, self-care retraining, and communication retraining among others.

Further Information Regarding Rehabilitation and Hospitals

Rehab Products Services to Over 100 Million Health Plan Members
Children and adults who have complex rehab needs are scattered throughout the nation. Although leading researchers are trying to find a cure for the severe physical disabilities that plague such patients, they need help living their daily lives now.

ICD - the International Center for the Disabled
The ICD is a nonprofit, outpatient rehabilitation center located in New York City that serves people with disabilities from all age groups. The organization offers rehabilitative services and presents services related to other developmental needs that people may have.

Healthcare Associated Acquired Infections
When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI).

Medical Tourism - Ethical Dilemmas
The appeal of such packages is obvious: healthcare consumers need not worry about any of the practical details of their trip - budgeting, travel arrangements or language barriers - and can instead focus on obtaining quality medical services combined with a vacation.

How Accurate are Hospital Report Cards?
A key statistic that consumer groups and the media often use when compiling hospital report cards and national rankings can be misleading, researchers report in a new study. The statistic is called the mortality index. A number above 1.0 indicates a hospital had more deaths than expected within a given specialty. Lower than 1.0 means there were fewer than the expected number of deaths.

The WHO Surgical Safety Checklist
In Health we are very good at setting up systems to detect when something has gone wrong and to investigate the causes. What we're not so good at yet is spending the time to avoid making the mistakes in the first place.

Majority of US hospitals will have Smoke-free Campuses
While hospital buildings are often smoke-free, a new study finds that by February 2008, 45 percent of US hospitals had adopted "smoke-free campus" policies, meaning that all the property owned or leased by the hospital, both indoors and outdoors, was smoke-free and there were no designated smoking areas on those properties.

Nonprofit Nursing Homes Provide Better Care
A major new statistical review of 82 individual research studies has revealed that nonprofit nursing homes deliver, on average, higher quality care than for-profit nursing homes. The findings could have a bearing on the present debate about the role of for-profit firms in U.S. health reform.

Fumbled Handoffs can Lead to Medical Errors
Poor communication of the outcomes of medical tests whose results are pending at the time of a patient's hospital discharge is common and can lead to serious medical errors in post-hospitalization medical treatment.

Home Help for Elderly - Bestowing New Life
If you have elderly relatives at home you know how hard it is to take care of them, especially when they are seriously ill or completely unable to perform normal regular activities. Home care providers play an important part here.

Uninsured Account for Nearly 20 Percent of Emergency Room Visits
"Our health care system has forced too many uninsured Americans to depend on the emergency room for the care they need," said Secretary Sebelius. "We cannot wait for reform that gives all Americans the high-quality, affordable care they need and helps prevent illnesses from turning into emergencies."

Compare Hospital Ratings
On average, 1 in 5 Medicare beneficiaries who are discharged from a hospital today will re-enter the hospital within a month. Reducing the rate of hospital readmissions to improve quality and achieve savings are key components of President Obama's health care reform agenda. Research has shown that hospital readmissions are reducing the quality of health care while increasing hospital costs.

Things to do in Hospital for Children and Adults
Most hospitals already have a few things you can do to pass the time, like hospital libraries and TV rooms, but it's best to find out before you go into hospital what they have in the particular hospital you will be an inpatient in, so you know what to bring with you for your stay.

Health Care Outcome Boost Needs Better Studies
Evidence suggests that outcomes in many clinical settings leave a lot to be desired, which means that research into quality improvement (QI) in clinical care has the potential to greatly improve the lot of patients. Now a study in the journal Medical Care Research and Review published by SAGE suggests that both theoretical and practical improvements in QI effectiveness studies could make these into much more powerful tools for positive change.

Hospitals with Internet Access
Access to e-mail and the Internet including wifi is everywhere these days, from coffee shops to cruise ships. So why not have the Internet in hospitals, where patients can take their mind off their health conditions and surf or instant message while lying in bed? Public Access Internet Service is an excellent way for patients and guests to stay connected in a hospital facility.

Neurosurgery with Transcranial MR-guided Ultrasound
The Magnetic Resonance Center of the University Children's Hospital Zurich has achieved a world first break through in MR-guided, non-invasive neurosurgery. Ten patients have been successfully treated by means of transcranial high-intensity focused ultrasound. This fully non-invasive procedure opens new horizons for neurosurgery and the treatment of different neurological brain disorders.

Hospitalized Patients Need Better Understanding of CPR and Outcomes
Many hospitalized patients overestimate their chance of surviving an in-hospital cardiac arrest and do not know what CPR really involves, a University of Iowa study has shown.

Pay-for-performance May Benefit Doctors Who Care For Very Sick
Physicians who treat patients with multiple health problems will fare well under pay-for-performance, which bases physician reimbursement on the quality of care provided, said researchers at Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center in Houston in a report in the current issue of the journal Circulation.

Hospital Care Varies for Children with Urinary Tract Infections
More than 45,000 infants and children in the United States are hospitalized each year for urinary tract infections, but a new study reveals significant variability across hospitals in treatment and outcomes.

Online Doctor Ratings - Examining a Physicians Credentials
With so many new sites offering free anonymous doctor ratings and information about physicians credentials, consumers expect to be able to find out everything about their doctors.